Treatment Of Phobia Research Articles

Use of virtual reality in dentistry: Literature review

<p>Virtual reality (VR) allows its application in different fields, such as healthcare. In dentistry, this technology has enormous potential, in the educational and clinical setting. Its applications are of growing interest and importance in dentistry, especially in teaching, since it offers interactivity and high effectiveness in learning. In the treatment of dental treatment phobia, this technology is also promising, as it shows satisfactory results, and in the surgical area it has a high potential for complex treatments, allowing predictable and safe results. However, future studies should focus on establishing technological standards with high data quality and on the development of approved applications for clinical routine. Therefore, the aim of this literature review was to provide clarifications on the knowledge and scientific development of VR in dentistry.</p>

A Case Study on the Deployment of a Tactile Internet Application in a Hybrid Cloud, Edge, and Mobile Ad Hoc Cloud Environment

The tactile Internet is the next step after the Internet of Things (IoT). It enables the steering and control of virtual and real objects through the Internet and requires a very low round trip latency. This article is devoted to a case study on the deployment of a tactile Internet application in a hybrid cloud, edge, and mobile <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">ad hoc</i> cloud environment. We deploy a remote phobia-treatment application as a set of components. Remote phobia treatment allows phobia patients to have therapy sessions under the guidance of an expert therapist located remotely, with patients and therapist sharing the same virtual reality (VR) environment. A three-layer architecture (cloud, edge, and mobile <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">ad hoc</i> cloud) is proposed for the deployment. A prototype is built with Microsoft Azure at the cloud layer, laptops at the edge layer, and smartphones at the mobile <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">ad hoc</i> cloud layer. End-users are equipped with an HTC VIVE headset for VR rendering and Gloveone gloves for haptic sensations rendering. Extensive performance measurements are made by varying the component deployment patterns as well as the distance between the therapist and patient. Our results demonstrate clearly that the addition of mobile <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">ad hoc</i> cloud to the edge and cloud does bring added value in terms of latency reduction when deploying tactile Internet applications.

Virtual reality in clinical practice.

Virtual reality in clinical practice.

A Platform for Exposure Therapy and Telemedicine, Using Mixed Reality Technology

Exposure therapy is the most effective treatment for specific phobias, social phobia, OCD, and PTSD. Even though exposure therapy is effective, only a third of the patients receive treatment because of lack of access to feared objects/situations in the clinic, lack of diversity of available objects, and very limited control over their behaviors. Treatment is also limited to the clinic office context, and not the real life experiences.

Perceived helpfulness of treatment for specific phobia: Findings from the World Mental Health Surveys

BackgroundAlthough randomized trials show that specific phobia treatments can be effective, it is unclear whether patients experience treatment as helpful in clinical practice. We investigated this issue by assessing perceived treatment helpfulness for specific phobia in a cross-national epidemiological survey. MethodsCross-sectional population-based WHO World Mental Health (WMH) surveys in 24 countries (n=112,507) assessed lifetime specific phobia. Respondents who met lifetime criteria were asked whether they ever received treatment they considered helpful and the number of professionals seen up to the time of receiving helpful treatment. Discrete-event survival analysis was used to calculate conditional-cumulative probabilities of obtaining helpful treatment across number of professionals seen and of persisting in help-seeking after prior unhelpful treatment. Results23.0% of respondents reported receiving helpful treatment from the first professional seen, whereas cumulative probability of receiving helpful treatment was 85.7% after seeing up to 9 professionals. However, only 14.7% of patients persisted in seeing up to 9 professionals, resulting in the proportion of patients ever receiving helpful treatment (47.5%) being much lower than it could have been with persistence in help-seeking. Few predictors were found either of perceived helpfulness or of persistence in help-seeking after earlier unhelpful treatments. LimitationsRetrospective recall and lack of information about either types of treatments received or objective symptomatic improvements limit results. ConclusionsDespite these limitations, results suggest that helpfulness of specific phobia treatment could be increased, perhaps substantially, by increasing patient persistence in help-seeking after earlier unhelpful treatments. Improved understanding is needed of barriers to help-seeking persistence.

Vr exposure in cbt is effective and efficacious treatment for simple phobia (flight phobia)

IntroductionThe virtual environment with realistically rendered fear-inducing stimuli is enough to conduct VR exposure therapy (VRE), although the total control over the virtual environment also enables presentation of stimuli, contexts, and tasks not possible in in vivo exposure therapy (i.e. flight etc.)30 randomized controlled trials revealing high efficacy and effect sizes comparable of VRE-CBT to in vivo exposure therapy. Aerophobia is a very frequent limitation and affect 25% of the population and 30% of the subjects who fly make habitual use of anxiolytics.ObjectivesThe aims of this study is to show that conducting VR exposure in CBT for simple phobia (flight phobia) is effective and is an efficacious treatment for fear and anxiety,Vs other treatments.MethodsParticipants (n = 39; age between 19 and 60 years) in the active arms received individual CBT VR exposure for six sessions and outcome was assessed with questionnaires: MSPS;Rathus Assertiveness Scale (RAS); HAM-A; QMAV; QSAV – (Flying fear); QoL INDEX and a behaviour avoidance test (really take the plane). Wilcoxon tests was using for the statistical analysis.Results36 subjects managed to take the plane at the end of treatment and the results obtained showed a significant difference between “before treatment (T0) and after (T1)” with the exception of the Rathus test. All the SF-36 scales show a significant difference between “before-after”. 3 subjects was dropped outConclusionsUsing VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure.DisclosureNo significant relationships.

Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one’s ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.

Virtual Reality Therapy in Mental Health.

Initially designed for the treatment of phobias, the use of virtual reality in phobic disorders has expanded to other mental health disorders such as posttraumatic stress disorder, substance-related disorders, eating disorders, psychosis, and autism spectrum disorder. The goal of this review is to provide an accessible understanding of why this approach is important for future practice, given its potential to provide clinically relevant information associated with the assessment and treatment of people suffering from mental illness. Most of the evidence is available for the use of virtual reality exposure therapy in anxiety disorders and posttraumatic stress disorder. There is hardly any evidence that virtual reality therapy is effective in generalized anxiety disorder and obsessive-compulsive disorder. There is increasing evidence that cue exposure therapy is effective in addiction and eating disorders. Studies into the use of virtual reality therapy in psychosis, autism spectrum disorder, and attention deficit hyperactivity disorder (ADHD) are promising.

Phobia Treatment with Face-Your-Fear VR App

Technology plays an important role in people’s daily life, for they depend on it to perform many tasks. Among the prominent technologies are smartphones and Virtual Reality (VR). Developing mobile apps and integrating VR technology allow users to experience an artificial environment as if it is real such as the simulation of phobias. This research paper proposes a mobile application named Face-Your-Fear (FyF) integrating VR to help any user to live a cybernetic experience, overcome the illness, know about phobia symptoms, and get extra information on two types of phobia: aquaphobia and achluophobia. Its architecture, features, development, interfaces and limitations are presented, including the main results of the qualitative survey to users.

Using targeted cognitive behavioural therapy in clinical work: a case study

Abstract Research shows high levels of complex co-morbidities within psychiatric populations, and there is an increasing need for mental health practitioners to be able to draw on evidence-based psychological interventions, such as cognitive behavioural therapy (CBT), to work with this population effectively. One way CBT may be utilised when working with complexity or co-morbidity is to target treatment at a particular aspect of an individual’s presentation. This study uses a single-case A-B design to illustrate an example of using targeted diagnosis-specific CBT to address symptoms of a specific phobia of stairs in the context of a long-standing co-morbid diagnosis of schizophrenia. Results show the intervention to have been effective, with a change from a severe to mild phobia by the end of intervention. Clinical implications, limitations and areas for future research are discussed. Key learning aims (1) There are high levels of co-morbid, complex mental health problems within psychiatric populations, and an increasing need for mental health practitioners to be able to work with co-morbidity effectively. (2) Cognitive behavioural therapy (CBT) remains one of the most well-evidenced psychological interventions with a large amount of research highlighting the effectiveness of diagnosis-specific CBT. (3) One way evidence-based diagnosis-specific CBT approaches could be utilised when working with more complex co-morbidity may be to target an intervention at a specific set of symptoms. (4) An example of using a targeted CBT intervention (to tackle a specific phobia of stairs in the context of a long-standing co-morbid diagnosis of schizophrenia and ongoing hallucinations) is presented. The outcomes show significant changes in the specific phobia symptoms, suggesting that CBT can be effectively used in this targeted manner within real-world clinical settings. The impact of co-morbid mental health difficulties on therapeutic process and outcomes are highlighted. (5) The use of cognitive restructuring techniques was identified as key to engagement and therapeutic process, supporting the importance of including cognitive techniques in the treatment of phobias compared with purely behavioural exposure-based interventions.

Augmented reality for the treatment of arachnophobia: exposure therapy

PurposePeople who suffer from phobias try to avoid a specific object or feared situation by creating a great obstacle that causes serious consequences in their daily life; the most effective way to deal with a phobia is through exposure therapy, which according to one of the most important principles of psychology states that to overcome a fear you have to face it. The purpose of this paper is to develop a mobile application based on augmented reality (AR) for the treatment of spider phobia (Araneae).Design/methodology/approachThe application development methodology was divided into two phases: design where sketches were made according to functional requirements, and the client server model was used for user queries and the development phase where the modules for the information of the phobia; and visualization of the arachnid in different morphological forms was implemented through the development tools.FindingsThe findings of this study, in this sense, state that it was possible to overcome the phobia in an essential way by ceasing to perceive harmless things as dangerous, helping them to manage stress and keep them under control.Originality/valueAllowing to face their fears in support of existing therapeutic processes through images with progressively AR, being an innovative and accessible treatment from an economic, technological and professional point of view.

A Freshening Breath of Insight

A Freshening Breath of Insight

The clinical potential of augmented reality.

Augmented reality (AR) is a rapidly emerging technology that superimposes digital objects onto real-world scenes as viewed in real time through a smartphone, tablet, or headset. Whereas AR has been adopted for retail, entertainment, and professional training, it also has potential as a novel, mobile, and efficacious treatment modality for psychological disorders. In particular, extinction-based therapies (e.g., anxiety, substance use disorders) could utilize AR to present stimuli in natural environments, enhancing generalizability beyond the clinic. The limited psychological literature on AR has focused on the treatment of simple phobias. Here, with the goal of bringing this technology to the attention of clinicians and researchers, we describe AR, contrast it with virtual reality, review the theoretical foundation for extinction-based therapies, provide examples for the treatment of substance use disorders, and identify theoretical, practical, and implementation-based research questions.

Mindfulness Based Specific Phobia Intervention: A Pilot Study of Dissociated Ego State Resolution

This pilot study was designed to investigate the efficacy of a mindfulness based intervention for the treatment of needle phobia. The research question was whether one session of the dissociated ego state [DES] trauma release intervention would result in significant and durable release of needle phobia. It was hypothesized that the process tested in this study may reduce needle phobia by locating, identifying, and engaging with a dissociated aspect of the psyche developed from earlier trauma. Six participants who self reported fear of needles and resulting avoidance of medical assistance completed one 60-minute, individual session of a mindfulness based protocol for the release of specific phobia. After the DES intervention session, all participants but one reported reduced subjective units of distress while holding the needle against their skin: reduction of 61% post-test, 71% at 3-month follow-up, and 70% at 6-month follow up. Results at 6-month follow-up were statistically significant despite small sample size. Future investigations should involve larger sample sizes, populations drawn from various settings, more facilitators and a randomized, waitlist group.

Decrease in amygdala activity during repeated exposure to spider images predicts avoidance behavior in spider fearful individuals

Spider phobia is characterized by exaggerated fear of situations where spiders could be present, resulting in avoidance of such situations and compromised quality of life. An important component in psychological treatment of spider phobia is exposure to phobic situations that reduces avoidance behaviors. At the neural level, amygdala responses to phobic material are elevated, but normalizes following exposure treatment. To what extent amygdala activity decreases during a session of repeated phobic stimulation, and whether activity decrease is related to subsequent avoidance is not well studied. We hypothesized reduced amygdala activity during the course of repeated exposure to spider pictures, and that the degree of reduction would predict subsequent avoidance of spider pictures. To test our hypothesis, functional magnetic resonance imaging was performed in 45 individuals with spider fear during repeated exposure to spider pictures. Results showed that repeated exposure to spider stimuli attenuated amygdala reactivity and individual differences in activity reductions predicted subsequent avoidance behavior to spider pictures in an incentive-conflict task, with larger attenuations predicting less avoidance. At 6-month follow up, initial reductions in amygdala activation still predicted avoidance. This result demonstrates that reduction in amygdala responses is related to clinically meaningful outcomes in human anxiety, and suggests that within-session reductions in amygdala responses could be an important mechanism explaining the clinical effects of exposure therapy.

Stress modulation of fear and extinction in psychopathology and treatment

Abstract The glucocorticoid cortisol, a major player in the development of stress-related psychopathology, can also be used for the augmentation of extinction-based psychotherapies (e.g., exposure therapy). Substantial evidence supports its beneficial effects in the treatment of post-traumatic stress disorder and specific phobias. In this review, we first present the role of stress and cortisol in the development of maladaptive emotional memories. Then, we describe the mechanisms that may account for the cortisol-induced augmentation of exposure, namely, the enhancement of extinction memory consolidation and the reduction of the contextual dependency of the extinction memory. Finally, we discuss several considerations and limitations for the use of cortisol in psychotherapy, focusing on the possible adverse effects of cortisol in a reconsolidation-based (as opposed to extinction-based) intervention.

A randomised wait-list controlled pilot trial of one-session virtual reality exposure therapy for blood-injection-injury phobias

Virtual reality exposure therapy (VRET) has been recognized as an effective treatment for specific phobias and has the potential to overcome the limitations of traditional in vivo exposure therapy (e.g., acceptability). No past research has evaluated the efficacy of VRET for the treatment of blood-injection-injury (BII) phobia. Therefore, we conducted a randomized controlled trial to examine the acceptability and efficacy of a single-session VRET intervention for BII phobias. Participants who met DSM-5 criteria for BII phobia (N = 43) were randomized to VRET or a waiting list control group, and completed self-report measures of BII severity (Medical Fear Survey [MFS] and Multidimensional Blood Phobia Inventory [MBPI]) and dental anxiety (Modified Dental Anxiety Scale), as well as clinician ratings of BII phobia severity and catastrophic cognitions at baseline, one-week post-treatment, and 3-month follow-up. We found medium to large differences in catastrophic cognitions (probability [g = 0.88] and cost [g = 0.66] ratings), favouring VRET. We found moderate to large differences favouring VRET on the MBPI Injection and Injury fears subscales (g's=0.64–1.14) at one-week post-treatment and 3-month follow-up, and on the MBPI Fainting subscale (g = 0.84) and Injections subscale of the Medical Fear Survey (g = 0.63) at follow-up. There were no other significant group differences. These findings provided some initial evidence to suggest that a single-session VRET may provide some improvements in fears of injections, injury, and fainting. While it may be a useful adjunct or interim step before in vivo exposure therapy, it is not sufficient as a standalone treatment for BII phobia.

Virtual Reality and Fear of Shark Attack: A Case Study for the Treatment of Squalophobia

Research treatment protocols are rare regarding an unusual anxiety disorder, namely the fear of sharks (squalophobia). As a possible solution, the effectiveness of virtual reality (VR) exposure therapy for this phobia was tested. The advantage of using VR becomes clearer when a real life set up is impractical, such as exposing a phobic patient to a feared large marine organism, the shark. The effects were evaluated in a single case study involving multiple context-graded aquatic virtual environments with a virtual shark and using affordable VR apparatus and software. Assessment was based on self-report questionnaires. Scores the psychometric instruments exhibited a discernable reduction in fear toward sharks. Such gains were maintained at a 12-month follow-up. Presence rates indicated immersion when confronted to a three-dimensional (3D) virtual shark. This initial study revealed the potential of VR for the treatment of marine biota phobia and its potential to recreate diverse situations for exposure therapy.

Effects of repeated exposure to fearful and disgusting stimuli on fear renewal in blood-injection-injury phobia

Although exposure is effective for blood-injection-injury (BII) phobia, fear often returns after treatment. While disgust has been implicated in BII phobia, its effects on fear renewal are unclear. To address this knowledge gap, the present study examined the effect of repeated video exposure to fearful and disgusting stimuli in multiple contexts on fear renewal in BII phobia. Individuals with BII phobia (N = 57) were randomized to Disgust-Specific Exposure (DSE) which included exposure to disgusting but threat-irrelevant stimuli (i.e., vomit), Fear-Specific Exposure (FSE) which included exposure to threat-relevant stimuli (i.e., injections), or General Negative Exposure (GNE) which included exposure designed to elicit negative affect (i.e., tornado) without being disgusting or threat-relevant. During session one, participants watched a pre- and post-exposure assessment injection video (“pre/post assessment”), and a novel injection video after exposure to assess renewal effects (“novel 1”). Participants came in one week later to rate the same videos, and a new injection video (“novel 2”). For week one outcomes, comparisons of covariate adjusted means indicated the fear-specific group reported significantly lower levels of anxiety than the general-negative group to the post-exposure and novel 1 stimulus. When presented with the post-exposure stimuli during week two, the disgust-specific and fear-specific groups reported significantly lower levels of anxiety than the general negative group. The fear-specific group also reported significantly lower levels of anxiety than the disgust-specific and general-negative groups when presented with novel 1 and novel 2 stimuli at week two. These findings suggest that repeated exposure to threat-relevant cues in multiple contexts does reduce the return of anxiety. However, repeated exposure to disgusting but threat irrelevant stimuli may also produce some therapeutic effects. The implications of the integration of disgust-relevant processes into exposure-based treatment of BII phobia are discussed.

VR virtual reality technology and treatment progress

Fear is a basic emotion of human beings. Normal people will have a fearful stress response when they face dangerous and threatening stimuli.Normal fear helps individuals to mobilize their physical and psychological functions to respond, and is an individual's need for survival and development. But environmental objective things or irrational fear and tension and with marked autonomic disorder is a disease that phobia (Phobia). Acrophobia is a common phobia. At present, the treatment of phobia is mainly desensitization technology. VR technology provides new ideas for the treatment of phobia. This article will introduce its progress.